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A COMPARATIVE STUDY ON THE ROLE OF BILATERAL INTERNAL ILIAC ARTERY LIGATION FOR ARRESTING THE OBSTETRIC HEMORRHAGE

Dr Qurat Ul Ann Butt, Dr Syeda Fatima Tu Zahira, Dr Hamza Abdul Malik

Objective: The aim of this study is to examine the role of the bilateral internal iliac artery ligation (BIAL) in controlling the sever haemorrhage after the birth of the child. Methodology: This study was conducted at Jinnah hospital Lahore and almost completed in the duration of one and half year from July 2017 to December 2018. All the patients who are included in this study are those patients which are patients of sever obstetric haemorrhage and they are the patients who needs a BIAL, all the medical history and their details are recorded on the proforma. The major outcome measures to control the haemorrhage was the effectiveness, which we analyze by the per-operative assessment to stop the bleeding from vagina or intraperitoneal and if it is essential then additional hysterectomy will be carried out. Result: In the duration of this study only eight patients passes through the process of BIAL, in which three of them due to atony were for PPH, two of them were for placenta Previa and one was for placenta increta, coagulopathy and rupture uterus. During the study there were three patients who needed surgery, I which one was underwent for the BIAL due to failure of control the bleeding, the failure rate of the bleeding was 16.66%. Disappointment in the control of the bleeding was instantly obvious and there was no patient who needed a re-laparotomy. Occurrence of one maternal death in two women developed wound infection due to coagulopathy and its complexities. During the patients stay in the hospital none of the patient have ischemia problem or any iliac vein injury. Conclusions: In the conclusion of our study we have found out that the BIAL procedure is effective and safe for the treatment of the sever obstetric haemorrhage and protection of reproductive capacity in future. KEY WORDS: Devascularization, Hemorrhage Rupture Uterus, Postpartum, Emergency Hysterectomy.

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